► Vendor Management
We work with clients and their vendors to make sure plan changes are properly understood, systems are correctly set-up, plan descriptions are updated, and vendors are prepared to manage and administer plans as expected.
Vendor evaluation and management is frankly one of our greatest areas of expertise. We pay careful attention to vendor performance and benchmark their results against our database of clients and Roundtable members. We also manage performance and expectations throughout the year via scheduled (often bi-weekly) update calls and quarterly meetings.
► Renewal Negotiations
We start the renewal process by being professional and demanding. Administration fees and premium rates need to be supportable (based on plan data) and competitive. The biggest cost items for most health and welfare benefit programs are medical and prescription drug costs. As a result, we concentrate the majority of our plan management efforts on these — especially high-cost claimants and specialty drugs.
Our standard approach is to structure multi-year deals and, unless the vendor is underperforming, to execute at least one renewal before taking the business to market. Generally, once every three to five years, a policy or service contract is taken to market. This keeps vendor pricing competitive and minimizes the disruption and cost associated with vendor turnover. The primary exception to this general philosophy is stop loss insurance. Some PBM contracts also require annual reviews.
Stop loss insurance is designed to protect a plan’s financial position from the potentially disruptive cost of “shock claims.” The stop loss insurance market is very dynamic. As such, we typically request competing proposals each year from a number of stop loss carriers on the plan’s behalf. As part of this process, we will analyze responses, negotiate terms, conditions and pricing, and work through detailed contract language with you and the preferred carrier to minimize protection gaps.
We won’t sell you our own captive insurance layer of stop loss like protection. We have found these arrangements to primarily benefit the broker sponsoring them. It creates “stickiness” for the broker. However, it is also too restrictive to enable plan sponsors to fully capitalize on a chronically dynamic insurance market.
We present our views on legislative and regulatory developments as part of our Annual Review and Planning Report. Additionally, our regular Legislative Updates deal with legal and regulatory matters and are published as new regulations are issued. You can find samples archived on our website.
Besides our Legislative Updates, as laws and regulations are released, we quickly inform clients via phone calls and discussions. We also provide regular client-specific reviews of the impact of evolving ACA, Mental Health Parity Act, CAA and other health and welfare regulations as required to help you make timely decisions.
In addition to our retained ERISA counsel, we have also co-hosted employer roundtables throughout the state with Thompson Hine’s ERISA team for over 12 years. These roundtable meetings are designed to facilitate employer-to-employer sharing and discussion of current compliance and plan management issues.
We understand that successful open enrollment and other plan change implementations can often hinge on effective employee communications.
While we’ve always provided clients with communications services to support our health and welfare benefits consulting work, a recently expanded partnership with longtime collaborator Workforce Communication has dramatically enhanced the breadth and depth of that offering.
As a result, we are confident in our ability to creatively engage your workforce using any one or a combination of these communications vehicles:
- Print Collateral
With the high cost of health care, most employers are struggling to provide competitive health benefits for eligible plan members — let alone ineligible ones. Family dynamics are changing — the traditional family unit is becoming less common and single-parent and “blended” families are more prevalent. Whether intentional or not, employees often enroll plan members that are not eligible. This is why one of our Fortune 200 clients coaxed us into providing this service over 15 years ago. To date, we have never conducted an eligibility audit that didn’t more than pay for itself.
It’s a company’s fiduciary responsibility to administer the plan according to plan documents and only provide benefits for those who are eligible. Our Eligibility Audits identify dependents that should not be covered under the plan. By removing those who are ineligible, companies are not only fulfilling their fiduciary responsibility, but saving a substantial amount of money.
► Benefits Admin + Outsourcing
We provide plan sponsors with customized administrative support for members and retirees. Services can be provided on an ongoing basis or tied to a specific event (i.e., Open Enrollment). Chelko’s Center for Benefits Management has been providing administrative support services for 15 years, serving clients across all industries. Our high-touch, customized approach minimizes employee disruption and internal HR involvement while maintaining the highest standards of employee privacy and data security.